Brain-derived neurotrophic factor (BDNF) levels and subjective sleep quality in the first trimester of pregnancy among Myanmar migrant workers in Samut Sakhon province, Thailand: a secondary data analysis

Abstract

Background: During pregnancy, mother will face many challenges in this time because so many things will change to their health, mental health, family and social. Result from these change lead pregnant woman to have mental illness both antepartum and postpartum period. Depression and poor sleep quality are common mental health problem during pregnancy, and these symptoms have effect to mother and child health. Brain-derived neurotrophic factor (BDNF) is one of the biomarkers that association with depression and sleep quality during pregnancy. Migrant people are risk group that will have treatment gap from Thailand health system. Samut Sakhon is the province that have migrant 2nd highest in Thailand after Bangkok. The objective of this study was to examine association between depression and sleep quality to BDNF level among pregnant migrant group at 1st trimester in Samut Sakhon, Thailand.

Methodology: This research was a cross-sectional study which used secondary data from birth cohort study conducting between June 2018 to August 2019 on Myanmar migrants in Samut Sakhon, Thailand. A total of 108 participants was recruit to this study from data of birth cohort study that have all data to analysis. The sociodemographic data and health behavior were assessed by self-report questionnaire. Depression was assessed by Patient Health Questionnaire 9 (PHQ-9) questionnaire. Sleep quality was assessed by Pittsburgh Sleep Quality index (PSQI) questionnaire. Plasma BDNF levels were measured by enzyme-linked immunosorbent assay. Binary logistic regression to evaluate association between BDNF to depression and sleep quality.

Result: From 108 participants, 36 participants (33.3%) have mild to severe depression, 31 participants (28.7%) have poor sleep quality and median range of BDNF was 6.38 ng/ml which used to separate into high (> 6.38) and low (≤6.38) BDNF group. After adjusted for confounder, we found that depression and sleep quality was significant association with BDNF level. For depression, mild to severe depression group have higher BDNF level compared to no to minimal depression group (aOR 2.972, 95% CI 1.111,7.949, p-value 0.030). For sleep quality, poor sleep quality will have lower BDNF level compared to good sleep quality (aOR 0.359, 95% CI 0.132,0.972, p-value 0.044).

Conclusion: Depression and Poor sleep quality in pregnancy is associated with BDNF level. These 2 mental health problems can affect to maternal and newborn health. Thailand hospital should have system to screening depression and sleep quality in pregnancy that come for antenatal care at out patient unit.